| NPI | 1265769558 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103T00000X Psychologist (Licence: FL PY 8758)  | 
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 017635-1)  | 
| Enumeration Date | 2009-11-08 | 
| Last Update Date | 2016-12-07 |